Annals of Occupational and Environmental Medicine

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Migration of phthalates and per- and polyfluoroalkyl substances from paper and plastic drinking straws immersed in human saliva: a pilot migration study: Kiook Baek; Ann Occup Environ Med 2026;e39. Published online August 20, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e39 [Accepted]

Abstract PDF: Drinking straws contact the oral cavity directly, and children use them routinely, raising concern about exposure to various chemicals. In this pilot study, six paper and three plastic straws were immersed in human saliva for 10 minutes, and five per- and polyfluoroalkyl substances and two phthalates were quantified by liquid chromatography–tandem mass spectrometry and gas chromatography–mass spectrometry, respectively. Perfluorohexane sulfonic acid, perfluorooctanoic acid, and perfluorononanoic acid were below the limit of detection (LOD) in all samples; perfluorooctanesulfonic acid was above the LOD in the procedural blank and one paper straw, and perfluorodecanoic acid was above the LOD in two straw samples. Di-n-butyl phthalate, which was below the LOD in the blank, was detected up to 30.097 µg/L in paper straws and 45.974 µg/L in plastic straws. Di(2-ethylhexyl) phthalate was elevated in the procedural blank (14.240 µg/L), precluding quantitative comparison between materials; nevertheless, four paper straws and one plastic straw exceeded this background. This pilot study highlights the need for methodological refinement and further investigation.

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Original Article

Association between organochlorine pesticides, polychlorinated biphenyls mixture and cardiometabolic outcomes: Findings from the Korean National Environmental Health Survey (KoNEHS): Jinwoo Han, Jong-Tae Park, Jaeyoon Lee, Kyeongmin Kwak; Ann Occup Environ Med 2026;e42. Published online September 14, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e42 [Accepted]

Abstract PDF: Background
Environmental chemical exposures rarely occur as isolated compounds. Instead, individuals are typically exposed to complex mixtures originating from multiple sources. Therefore, evaluating the combined health effects of correlated environmental chemicals through mixture-based approaches is essential.
Methods
This study applied quantile g-computation, a regression-based method designed to estimate the joint effects of correlated exposures. Among 4,279 participants in cycle 5 of the Korean National Environmental Health Survey (KoNEHS), 1,383 participants were included in the final analysis. The exposure mixture included persistent organic pollutants (POPs), specifically organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs). Associations with cardiometabolic outcomes, including HbA1c and lipid profile indicators, were evaluated using six hierarchical regression models with increasing levels of covariate adjustment and stratification. For statistically significant results, the relative contribution and directional influence of individual chemicals within the mixture were quantified using estimated mixture weights.
Results
Across the hierarchical regression models, mixture effects were more pronounced for lipid metabolism than for glycemic outcomes. Within the OCP mixture, β-hexachlorocyclohexane and p,p’-DDE consistently showed the largest positive contributions. Within the PCB mixture, PCB74 and PCB153 were the dominant contributors, particularly for lipid-related outcomes.
Conclusions
Overall, these findings support the importance of mixture-based analytical approaches and suggest that dyslipidemia may represent a key pathway linking POP exposure to cardiometabolic risk.

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Original Article

Association between seafood consumption and urinary bisphenol concentrations in Korean adults: findings from the Korean National Environmental Health Survey (KoNEHS 2018–2020): Seong-Ho Moon, Kwang Hee Jo, Soonsu Shin, Jae-Hong Ryoo; Ann Occup Environ Med 2026;e40. Published online September 1, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e40 [Accepted]

Abstract PDF: Background
This study aimed to examine exploratory cross-sectional associations between seafood-consumption frequency and spot urinary concentrations of bisphenol A (BPA), bisphenol F (BPF), and bisphenol S (BPS) in Korean adults and to present descriptive sex-stratified estimates.
Methods
Seafood-consumption frequency was assessed using a semi-quantitative food frequency questionnaire, whereas BPA, BPF, and BPS were measured in a single spot urine sample and dilution-adjusted using covariate-adjusted standardization. We analyzed 4,201 adults from the Korean National Environmental Health Survey 2018–2020. Seafood consumption (six groups) was classified as rarely, ≤once/week, or >once/week. Sex-stratified survey-weighted logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for high exposure (≥75th percentile), adjusting for sociodemographic factors, health behaviours, and food-contact behaviours. Sensitivity analyses used survey-weighted linear regression with ln-transformed concentrations.
Results
Median urinary concentrations were higher in men than in women for all three bisphenols. In men, seaweed consumption >once/week was associated with higher odds of high BPA exposure (OR: 2.34; 95% CI: 1.18–4.63), whereas crustacean consumption >once/week was associated with lower odds of high BPA exposure (OR: 0.27; 95% CI: 0.10–0.75). In women, large fish/tuna consumption >once/week (OR: 1.76; 95% CI: 1.00–3.20) and crustacean consumption >once/week (OR: 2.20; 95% CI: 1.09–4.43) were associated with higher odds of high BPA exposure.
Conclusions
Seafood-frequency categories showed associations with spot urinary concentrations of BPA, BPF, and BPS. These cross-sectional findings do not establish a causal relationship or a specific exposure pathway. Longitudinal studies with repeated urinary measurements and more detailed assessment of seafood products, processing, and food-contact materials are needed to clarify these associations.

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Original Article

Personal and environmental determinants of oxidative stress among the residents of Ulsan, South Korea: a combined approach of statistical and machine learning models: Chiwon Sung, Dong Yeop Lee, Miso Lee, Chang Sun Sim, Inbo Oh, Jin-Hee Bang, Dong Yoon Kang, Jiho Lee; Ann Occup Environ Med 2026;e41. Published online September 1, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e41 [Accepted]

Abstract PDF: Background
This study aimed to identify personal and environmental factors influencing malondialdehyde (MDA) levels, measured using thiobarbituric acid reactive substances (TBARS) assay, among residents of Ulsan, South Korea.
Methods
A total of 909 adult residents of Ulsan, recruited between 2022 and 2024, participated in a survey and urine analysis. The dependent variable was the natural log-transformed TBARS value (Ln_TBARS). The study examined 47 independent variables, including personal characteristics, socioeconomic factors, work-related exposures, residential area, and living environment. Residential areas were classified into three groups (A, B, and C) according to potential exposure to industrial hazardous air pollutants, determined jointly by proximity to large-scale industrial complexes and modelled concentrations of benzene, toluene, and xylene. Stepwise multiple regression, least absolute shrinkage and selection operator (LASSO) regression, and random forest (ntree = 500) were applied and compared to identify factors influencing oxidative stress levels among Ulsan residents.
Results
Residential area had the greatest impact on oxidative stress across all three models. Group C showed significantly lower Ln_TBARS levels than those in group A (stepwise: β = −0.395, p < 0.001; LASSO coefficient = −0.529; random forest: %IncMSE = 17.07%). Age and female sex were also consistently associated with oxidative stress across all three models (stepwise: β = 0.319, p < 0.001; LASSO coefficient = 0.014; random forest: %IncMSE = 12.67%, and stepwise: β = 0.152, p < 0.001; LASSO coefficient = 0.154; random forest: %IncMSE = 6.93%).
Conclusions
Residential area was the strongest predictor of oxidative stress across all three analytical models, with higher urinary MDA among residents of areas closer to industrial complexes; older age and female sex were also consistent predictors. These findings, robust across conventional statistical and machine-learning approaches, support systematic environmental health monitoring and targeted policy measures for residents near industrial zones.

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Original Article

Association between seafood consumption and serum polyfluoroalkyl substance concentrations among Korean adolescents: the Korean National Environmental Health Survey (KoNEHS) cycle 5, 2021–2023: Hyun Joong Kim, Yongjin Kim, Dong-jae Seo, Jaewon Mun, Sunwoo Jeong, Shin-Goo Park, Yangwoo Kim, Hwan-Cheol Kim; Ann Occup Environ Med 2026;e38. Published online August 20, 2026; DOI: https://doi.org/10.35371/aoem.2026.38.e38 [Accepted]

Abstract PDF: Background
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants commonly found in seafood; however, evidence of dietary ingestion among adolescents remains limited. We aimed to evaluate the association between seafood consumption and serum PFAS concentrations among Korean adolescents.
Methods
This cross-sectional study used data from the fifth Korean National Environmental Health Survey (KoNEHS, 2021–2023). We included 827 adolescents aged 12–18 years. Serum concentrations of five PFAS compounds (perfluorooctanoic acid [PFOA], perfluorooctane sulfonic acid [PFOS], perfluorohexane sulfonic acid, perfluorononanoic acid [PFNA], and perfluorodecanoic acid [PFDeA]) were measured. Seafood consumption was assessed using a questionnaire and categorized as rarely consumed, monthly consumption, or weekly consumption. Complex sample general linear models were performed using log-transformed PFAS concentrations.
Results
Compared with rarely consumed, weekly fish consumption was significantly associated with higher serum concentrations of PFOA (B = 1.15; 95% confidence interval [CI]: 0.46–1.83; p = 0.001), PFOS (B = 2.14; 95% CI: 1.23–3.05; p < 0.001), PFNA (B = 0.28; 95% CI: 0.14–0.42; p < 0.001), and PFDeA (B=0.14; 95% CI: 0.05–0.23; p = 0.004), whereas monthly fish consumption was associated with higher PFOS and PFNA. Crustacean consumption showed positive associations with PFOA (B = 1.10; 95% CI: 0.57–1.63; p < 0.001), PFOS (B = 0.93; 95% CI: 0.24–1.61; p = 0.009), PFNA (B = 0.18; 95% CI: 0.08–0.28; p < 0.001), and PFDeA (B = 0.11; 95% CI: 0.05–0.16; p < 0.001) in the monthly group, whereas associations were attenuated in the weekly group. No significant associations were observed for large fish and tuna, seaweed, shellfish, or other seafood.
Conclusions
Fish and crustacean consumption were associated with serum PFAS concentrations among Korean adolescents, whereas other seafood types showed no significant associations. Future prospective studies with more detailed dietary assessments are warranted to clarify causal relationships.

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